Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T06:16:24.606Z Has data issue: false hasContentIssue false

The Classification of Psychiatric Morbidity in Attenders at a Dermatology Clinic

Published online by Cambridge University Press:  02 January 2018

S. C. Wessely*
Affiliation:
Maudsley Hospital, now Department of Forensic Psychiatry, Institute of Psychiatry
G. H. Lewis
Affiliation:
General Practice Research Unit, Institute of Psychiatry, and Honorary Senior Registrar, Bethlem & Maudsley Hospitals, London
*
Department of Forensic Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF

Abstract

Of a random sample of new attenders at a dermatology out-patient clinic, 40% were classified as suffering from a psychiatric disorder. There was no correlation between psychiatric morbidity and the severity or site of skin disease. Self-report measures of the behavioural impact of skin disease and attitudes to appearance were related to psychological morbidity. Except in subjects without visible skin pathology (5%) there was no evidence that psychiatric illness was an aetiological factor in the development of skin disease. Self-report measures were used to distinguish between those patients in whom psychiatric morbidity was closely related to skin disease (75%), and those in whom it may be coincidental (20%). Psychological care for the former group is most appropriately provided by physicians, who should be encouraged to improve their detection and management of psychiatric morbidity.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexander, F. & French, T. (1948) Studies in Psychosomatic Medicine. New York: Ronald Press.Google Scholar
Barth, J., Catalan, J., Day, A., et al (1987) Psychological aspects of acne and hirsutes. In Proceedings of the International Symposium on Dermatology and Psychiatry, Vienna, 31 May—2 June, 1987. Google Scholar
Beck, A. (1976) Cognitive Therapy and the Emotional Disorders. New York: International Universities Press.Google Scholar
Coles, R. (1966) Glossodynia: a psychosomatic problem. Transactions of the St John's Hospital Dermatology Society, 52, 7983.Google Scholar
Cronbach, L. (1951) Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297334.Google Scholar
Eller, J. (1974) Skin disorders and the psyche. Cutis, 13, 395416.Google Scholar
Feldman, E., Mayou, R., Hawton, K., et al (1987) Psychiatric disorder in medical in-patients. Quarterly Journal of Medicine, 241, 405412.Google Scholar
Figueria, M. & Faria, I. (1987) Expressed anxiety in psychosomatic patients with atopic dermatitis: cognitive-linguistic structures. In Proceedings of the International Symposium on Dermatology and Psychiatry, Vienna, 31 May—2 April 1987. Google Scholar
Goldberg, D. (1972) The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press.Google Scholar
Goldberg, D. (1986) Identifying psychiatric illness among general medical patients. British Medical Journal, 291, 161162.CrossRefGoogle Scholar
Goldberg, D., Eastwood, M., Kedward, H., et al (1970) A standardised psychiatric interview for use in the community. British Journal of Social and Preventive Medicine, 24, 1823.Google Scholar
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community. London: Tavistock.Google Scholar
Hardy, G. & Cotterill, J. (1982) A study of depression and obsessionality in dysmorphophobic and psoriatic patients. British Journal of Psychiatry, 140, 1922.CrossRefGoogle ScholarPubMed
Hawton, K. (1981) The long-term outcome of psychiatric morbidity detected in general medical patients. Journal of Psychosomatic Research, 25, 237243.Google Scholar
Hughes, J., Barraclough, B., Hamblin, L., et al (1983) Psychiatric symptoms in dermatology patients. British Journal of Psychiatry, 143, 5154.Google Scholar
Jobling, R. (1976) Psoriasis – a preliminary questionnaire study of sufferers. Subjective experiences. Clinical and Experimental Dermatology, 1, 233236.CrossRefGoogle Scholar
Johnstone, A. & Goldberg, D. (1976) Psychiatric screening in general practice. A controlled trial. Lancet i, 605608.Google Scholar
Kenyon, F. (1962) A psychiatric survey of a random sample of outpatients attending a dermatological hospital. Journal of Psychosomatic Research, 6, 129135.Google Scholar
Kenyon, F. (1966) The psychosomatic effects of acne. British Journal of Dermatology, 78, 344351.CrossRefGoogle Scholar
Koblenzer, C. (1983) Psychosomatic concepts in dermatology: a dermatologist-psychoanalyst's viewpoint. Archives of Dermatology, 119, 501512.Google Scholar
Lewis, G., Pelosi, A., Glover, E., et al (1988) The development of a computerised assessment for minor psychiatric disorder. Psychological Medicine, 18, 737745.Google Scholar
Lloyd, G. (1983) Medicine without signs. British Medical Journal, 287, 539542.Google Scholar
Mayou, R. & Hawton, K. (1986) Psychiatric disorder in the general hospital. British Journal of Psychiatry, 149, 172190.CrossRefGoogle ScholarPubMed
Musaph, H. (1976) Psychodermatology. In Modern Trends in Psychosomatic Medicine - 3 (ed. O. Hill), pp. 347362. London: Butterworths.Google Scholar
Owens, D. & Millard, L. (1987) Psychiatric assessment in dermatological non-disease. Proceedings of the International Symposium on Dermatology and Psychiatry, Vienna, 31 May—2 June 1987. Google Scholar
Querido, A. (1959) Forecast and follow-up. British Journal of Preventive and Social Medicine, 13, 334339.Google Scholar
Resch, F., Dietzel, M., Birsak, L., et al (1987) Differential aspects of emotional disturbance in patients with psoriasis and vitelligo. In Proceedings of the International Symposium on Dermatology and Psychiatry, Vienna, 31 May—1 June 1987. Google Scholar
Shepherd, M., Cooper, B., Brown, A., et al (1966) Psychiatric Illness in Primary Care. Oxford: Oxford University Press.Google Scholar
Sheppard, N., O'Loughlin, S. & Malone, J. (1986) Psychogenic skin disease: a review of 35 cases. British Journal of Psychiatry, 149, 636643.Google Scholar
Shuster, S., Fisher, G. & Harris, E. (1975) The effect of skin disease on self-image. British Journal of Dermatology, 99 (suppl. 16), 1819.Google Scholar
Van der Schaar, W. & Couperus, M. (1986). A psychosomatic study of skin diseases in ten adolescent girls. Proceedings of the 15th European Conference on Psychosomatic Research (eds J. Lacey & D. Sturgeon). London: John Libbey & Co.Google Scholar
Wessely, S. (1989) Dermatology. In Somatic Presentations of Psychiatric Disorder (ed. C. Bass). London: Blackwell.Google Scholar
Wilkinson, D., Borsey, D., Leslie, P., et al (1987) Psychiatric disorder in patients with insulin-dependent diabetes mellitus attending a general hospital clinic: (i) two-stage screening and (ii) detection by physicians. Psychological Medicine, 17, 515517.Google Scholar
Zigmond, A. & Snaith, R. (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361370.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.